Diabetes Epidemic in India Linked to Affluence Gone Astray

Cultural greatness is an elusive thing. To appreciate the brilliance of what a people have to offer generally takes education and a cultivated taste. That’s why instead of sitting down to enjoy some jazz or reading good literature, those new to Western culture so often plug in at the more pedestrian level.

Rather than symphonies, they gravitate to pop music. Instead of a finely-crafted novel, it’s a cheap TV sitcom that seems to strike a chord. And in the place of the fine cuisine the West has to offer, it’s the fried morsels of the fast food joints, the corporate world’s processed delights, and sugar.

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Food Tips on Maintaining a Diabetes-Free Life

Control your weight.

The more fresh vegetables and fruits you are eating, the better. Try for five servings of vegetables daily and one or two servings of fruit.

Use a drizzle of olive oil and a hefty sprinkle of good vinegar to enhance the flavor of vegetables.

Avoid dried fruits with their high sugar concentrations.

Pass on the sugar and fried food.

Pass on processed foods that generally have sugar and fat added.

Eat fish three times a week.

Choose beans and whole grains. Get an Indian cookbook to learn how to prepare great vegetarian fare.

Activity Tips on Maintaining a Diabetes-Free Life

Remember than every step counts. Shelve the remote control and get up out of the recliner frequently.

Better yet, turn off the TV and stay out of the recliner.

Cultivate the habit of the after-dinner walk. Even once around the block can make a difference over time.

Go to the gym. It’s amazing how inspiring it can be to work out around others who are similarly dedicated.

Take up swimming. Probably no other activity exercises more muscle groups and is as easy on the joints as swimming.

While daily activity of at least 30 minutes is recommended – or full aerobic workouts four times a week – do what you can at first. The idea is to start with something you like. Over time, nature will take its course and you’ll be amazed with the results.

Worse, when you are a member of a culture of people known to have a genetic predisposition for diabetes, this tendency to eat high-fat, high-sugar food can lead to health problems. In India, where out of a population of 1.1 billion, 75 million are projected to get adult-onset Type 2 diabetes over the next 20 years, people begin to take notice. The New York Times took notice as well – they ran a front page story on this trend in a September 2006 issue.

To put the 75 million figure in context, Wounds1 consulted World Health Organization (WHO) literature. While as of 2002, 150 million people worldwide were estimated to have diabetes, projections for the year 2025 are that the world figure will double to 300 million. Thus, half of them will be in India.

“Much of this increase will occur in developing countries and will be due to population growth, aging, unhealthy diets, and sedentary lifestyles,” the WHO states. “By 2025, while most people with diabetes in developed countries will be at least 65 years of age, in developing countries most will be in the 45 to 64 age bracket, and affected in their most productive years.”

According to the NYT’s analysis, the dramatic and widespread rise of the form of diabetes that has historically only affected older adults is a function of increasing incomes in India and the invasion of western fast food. Instead of the traditional lentils, rice, and fresh vegetables, many are opting for convenience foods that their new wealth allows. This trend, combined with the ubiquitous sweet shops in India and the money to frequent them much more often than usual, has thickened the middles of a formerly svelte people known more for yoga and meditation than diseases.

I remember when I visited a friend born in India in Chicago. Anju and I lunched at a proper Indian vegetarian place, but afterward she took me around the corner to the Indian sweets shop. There they were behind the glass, row after row of colorful sweets, some beckoning with tinted coconut, others decorated with pistachios. I tasted a pink sweet. It was mostly sugar – without discernable flour or butter – and eating it was like being transported to a high heavenly cloud. Needless to say, what followed was much choosing and wrapping and stowing, until I left toting a medium-sized take-out box filled with the delicacies.

My friend is slim. Her father was a yoga teacher and was even the model for a book on the subject. Thus, overindulging in sweets or anything that might adversely affect her body was not in Anju’s repertoire. Besides, she was a superb cook when it came to authentic Indian food. I still remember the first time I passed her door and smelled the aroma of cumin seeds being toasted in oil. In fact, that was a major reason we got acquainted since I adored her food and grew to have great respect for the centuries-old vegetarian cuisine.

Anju respected the traditional ways of her culture. Perhaps it was because she had come to the United States to study genetics. Or maybe it was due to the opportunity she had to observe Americans making their way through the snack and cookie aisles and fast food drive-throughs.

“It’s amazing,” she remarked once. “They don’t have to even get out of their cars to get what they want.”

The NYT coverage included the litany of pain that diabetics can endure: wounds that don’t heal, especially on the feet where poor circulation can result in serious infections, gangrene, and ultimately amputation; heart and circulation problems; and blindness. The paper also commented on the social and economic fall-out people in India are experiencing along with rising rates of Type 2 diabetes. Divorce is one example. A woman selling her gold jewelry to pay for her husband’s care in a nation where health insurance coverage is inadequate, is another.

“Diabetes unfortunately is the price you pay for progress,” A. Ramachandran, M.D., the managing director of the M.V. Hospital for Diabetes in Chennai, India told the NYT.

My friend Anju, who now lives and works in Boston with her husband and children, respectfully disagrees. “Look at me – and my brother too. Actually he’s been here in the U.S. longer than I have and came in the late 1980s. Now like me, he’s married and has a family, but he has not been lured into eating all the cheap American food. For us, we don’t feel right if we haven’t had one good Indian meal every day. So we stay healthy.”

Anju pauses for a moment and then adds that she’s not completely impervious to the lures of American culture. “I do love movies on the big screen. I’ll watch anything – at least I used to more before my children came along and I got busier than I ever imagined. Also the telephone – I love to call long distance. It used to be a problem, but now with the cheap plans, I don’t have to worry about that.

“But those things aside, I am so very glad that my husband and children and me, and my brother’s family – that we haven’t gotten into all the bad habits that are sweeping through India. You have to understand, though, that life has been so hard on so many over there – and for so long – that it’s only natural for them to jump at whatever pleasures are in their reach. It’s just too bad that in the case of food, what makes them feel good temporarily can ultimately rob them of precisely what they worked so hard to get. It’s sad, really. So very sad what we human beings seem to have to go through on our ways to finding wisdom.”

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